Provider Demographics
NPI:1295197473
Name:TRAN, HENRY LAM
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:LAM
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 COFFEE RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-9424
Mailing Address - Country:US
Mailing Address - Phone:909-469-9494
Mailing Address - Fax:909-620-7285
Practice Address - Street 1:1770 N ORANGE GROVE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3027
Practice Address - Country:US
Practice Address - Phone:909-469-9494
Practice Address - Fax:909-620-7285
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program